We have developed a procedure that is particularly useful for 1 paralytic or senile upper and lower eyelid laxity, 2 lateral canthal tendon laxity or malposition, and 3 iatrogenic phimosis associated with recurrent entropion or ectropion after traditional lid-shortening procedures. Lateral canthal tendon laxity or elongation is the primary problem in the majority of these cases, and eyelid tightening with use of lateral tarsal strips corrects this deformity. The midtarsal portion of the eyelid, which is usually resected in traditional lid-shortening procedures, is seldom elongated, and recurrences of laxity are common secondary to further stretching of lax tendons. The technique involves a lateral canthotomy and transection of the appropriate crus of the lateral canthal tendon. The eyelid is then split into anterior and posterior lamellae, and tarsal strips are fashioned from the posterior lamella. The tarsal strips are sutured to periosteum at the lateral orbital wall, adjusting the height and tension of the lateral canthus. This technique gives a normal appearance to the lateral canthal angle and has yielded good results in 51 cases.
The tarsal strip procedure.
Lateral tarsal strip versus Bick’s procedure in correction of eyelid malposition | Eye
The lateral canthus normally sits 1 to 2 mm higher than the medial canthus. With time, aging and gravity produce inferior displacement of the canthus. Numerous eyelid disorders can also result in lower eyelid or lateral canthal tendon laxity or malposition, requiring horizontal eyelid tightening or canthal repositioning. The lateral tarsal strip procedure has proven to be a useful technique in addressing these problems. Care must be taken when suspending the tarsal strip to the lateral orbital rim to preserve the almond shape of the lateral canthal angle.
Lateral tarsal strip surgery common for correcting ectropion
KOLOA, Hawaii — Every ectropion case is different and there are a variety of corrective surgical techniques, but the most traditional approach is lateral tarsal strip surgery, a speaker here. This is probably the most traditional approach, to do a lateral tarsal strip and tighten it. Lee, MD, said at Hawaiian Eye
Ophthalmology and Visual Sciences. This is Richard Allen at the University of Iowa. This video demonstrates the lateral tarsal strip procedure.